Provider Demographics
NPI:1235269697
Name:WINEGARNER, SHANNON E
Entity Type:Individual
Prefix:MS
First Name:SHANNON
Middle Name:E
Last Name:WINEGARNER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:940 CENTRAL PARK DR
Mailing Address - Street 2:STE 101
Mailing Address - City:STEAMBOAT SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80482
Mailing Address - Country:US
Mailing Address - Phone:970-879-1632
Mailing Address - Fax:
Practice Address - Street 1:940 CENTRAL PARK DR
Practice Address - Street 2:STE 101
Practice Address - City:STEAMBOAT SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80482
Practice Address - Country:US
Practice Address - Phone:970-879-1632
Practice Address - Fax:970-879-6774
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO164379163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health